Surgery

The bile ducts and gallbladder are comprised of a tube system, which drains digestive juice called bile from the liver to the intestine. The gallbladder is specifically designed as a storage system for bile and frequently develops stones, which can cause pain or other problems such as pancreatitis and jaundice. Conditions such as bile duct strictures and bile duct or gallbladder cancers are challenging problems which require multi-disciplinary management ensure rapid evaluation and treatment including advanced endoscopy (ERCP, EUS), surgery or chemotherapy.

The Hillcrest HPB surgical service is experienced in the management of a variety of biliary conditions using both open and minimally-invasive (robotic) surgical approaches. We offer treatments for the following bile duct and gallbladder conditions:

• Ampullary cancer & adenoma
• Bile duct injury
• Bile duct stricture
• Cholangiocarcinoma / bile duct cancer
• Choledochal cyst & choledochoceles
• Gallbladder cancer & polyps
• Sphincter of Oddi syndrome

Conditions such as bile duct strictures and bile duct or gallbladder cancers are challenging problems which require multi-disciplinary management. This is to ensure rapid evaluation and treatment for your condition. Our services include advanced endoscopy (ERCP, EUS), surgery and chemotherapy.

The duodenum is the first part of the small intestine where food begins the process of being absorbed after it leaves the stomach. In some conditions, patients can form pre-cancerous growths called polyps, which can cause bleeding and blockages. 

Advanced endoscopy techniques are often required to evaluate and remove early polyps and identify those which require surgery to remove. At Hillcrest, our HPB surgeons are skilled in the removal of duodenal cancers, tumors, and polyps. We also use HPB surgery to care for patients with hereditary polyposis, such as Peutz-Jeghers syndrome. Please note that some patients may also require chemotherapy afterwards to fully eradicate any remaining cancer cells.

The esophagus is an organ which starts in the neck and ends in the abdomen where it allows food to enter the stomach to begin the digestion process. Tumors and cancers of the esophagus and stomach often require the specialty of gastroenterologists with experience performing advanced endoscopic procedures like ablation and endoscopic ultrasounds. This is because esophagus and stomach cancers can be hard to correctly diagnose. 

At Hillcrest, our multidisciplinary teams are trained to diagnose and care for esophagus and stomach cancers using treatments like chemotherapy, radiation therapy, and surgery. We offer treatment for the following conditions:

• Esophageal cancers, including esophageal adenocarcinoma and esophageal squamous cell carcinoma.
• Esophageal perforation
• Esophageal and stomach tumors, including gastric and esophageal leiomyoma, esophageal-gastrointestinal stromal tumor (E-GIST).
• Stomach cancer, such as gastric adenocarcinoma

At Hillcrest, we empower patients with esophagus and stomach cancers to face their journey with confidence and the support of a highly skilled team focused on providing compassionate, expert care.

The pancreas is an organ in the abdomen which has both endocrine and exocrine functions. The exocrine portion makes enzymes which regulate digestion of carbohydrates, protein, and fat which facilitates absorption of food and vitamins in the intestines. The endocrine portion makes and secretes hormones which affect metabolism including insulin, glucagon, gastrin, somatostatin, and vasoactive intestinal peptide. Pancreatitis can be severe and life threatening, requiring urgent or emergent care and advanced treatments, such as endoscopic ultrasound and pancreatic surgery. Tumors or cancers of the cells making up the exocrine or endocrine functions of the pancreatic cancer can arise.

Our multidisciplinary team is equipped with the expertise needed to manage a wide range of pancreatic conditions, including:

• Acute pancreatitis: A sudden inflammation of the pancreas that can be life-threatening.
• Chronic pancreatitis: Long-term inflammation leading to severe symptoms and complications.
• Pancreas cysts: Growths that may increase cancer risk and require careful monitoring.
• Pancreas cancer: A challenging condition requiring specialized care including chemotherapy, radiation, and surgery.
• Pancreatic neuroendocrine tumor: This type of tumor forms in the endocrine cells of the pancreas, and can be benign or malignant.

Conditions such as pancreas cysts and chronic pancreatitis can lead to disabling symptoms, including an increased risk for pancreas cancer and should be periodically observed using imaging and/or endoscopy to ensure no progression or cancer is developing. Pancreatic cancer is a serious disease which requires multi-disciplinary management to treat the disease using chemotherapy, radiation and surgery.

The Hillcrest HPB Surgical team is experienced with both open and minimally-invasive surgical techniques and is a high-volume center for pancreatic surgery. We utilize the Da Vinci surgical robotic system to provide many types of pancreatic surgical procedures including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, and pancreatic drainage procedures such as Puestow and Frey procedures. Our dedicated team is proud to use one of the only robotic Whipple programs in the US to deliver the best possible outcomes for our patients.

The liver is an organ in the abdomen which filters toxins from the blood, regulates metabolism, synthesizes bile to aid digestion, and produces blood proteins. Conditions such as hepatitis and fatty liver disease are important to diagnose and treat to avoid long-term liver disease and even liver cancer. Other conditions such as liver cysts, hemangioma, focal nodular hyperplasia and adenomas can cause symptoms that limit your ability to function normally and can increase the risk for cancer or bleeding.

Liver tumors are best treated by multi-disciplinary teams specially trained in liver tumor management in order to not only cure the disease using surgery, chemotherapy, or other local therapies, but also to ensure the normal function of the liver. The Hillcrest HPB surgical service is experienced with surgical management of all types of liver tumors and is able to offer surgery for the liver using both open and minimally-invasive surgical techniques including the Da Vinci robotic surgical system.

Our surgeons use traditional and minimally invasive surgery to treat the following liver conditions:

• Acute hepatitis
• Cholangiocarcinoma
• Cirrhosis
• Focal nodular hyperplasia
• Hepatic adenoma
• Hepatic hemangioma
• Hepatocellular carcinoma
• Liver abscess
• Liver cysts
• Liver metastases (i.e., colon, rectal, breast, neuroendocrine)
• Polycystic liver disease
• Viral hepatitis (i.e., Hepatitis C, Hepatitis A, Hepatitis B)

Conditions such as hepatitis and fatty liver disease are important to diagnose and treat to avoid long-term liver disease and even liver cancer. Other conditions such as liver cysts, hemangioma, focal nodular hyperplasia and adenomas can cause symptoms that limit your ability to function normally and can increase the risk for cancer or bleeding.

Liver tumors are best treated by multi-disciplinary teams specially trained in liver tumor management in order to not only cure the disease using surgery, chemotherapy, or other local therapies, but also to ensure the normal function of the liver.

The peritoneum is the lining of the abdomen, which allows fluid and other substances to circulate. In some patients, cancer from an organ in the abdomen — such as the colon, rectum, appendix, stomach or ovary — can spread to the peritoneum, or a cancer can form from the peritoneum (i.e., mesothelioma). Because the peritoneum is difficult to treat with traditional chemotherapy in the bloodstream, special techniques are used to remove the cancer from it and treat it with heated chemotherapy.

Our HPB surgeons offer treatments for peritoneal mesothelioma, peritoneal carcinomatosis, and pseudomyxoma peritonei. These diseases require multi-disciplinary teams trained in the management of peritoneal cancers to determine the appropriate timing of treatments and ensure the best outcome for patients.

For more information about our HPB surgery program, please call 918-582-6544.